Patients who have been suffering for years from high blood sugar concentration can expect serious consequences for their entire bodies. Accurate knowledge of the complications that may arise in the course of the disease is important not only for the exam. Physicians may significantly contribute to the problem, so that amputations, blindness, kidney damage and cardiovascular disease can be avoided.

00:01
The skin manifestations that you would find…
underneath the armpit here, we have darkening.
00:07
This is called thickening of your keratinocytes
which then appears dark.
00:12
That is the dissection of the term that I’ve
given you called Acanthosis nigricans.
00:17
Usually, this is due to, well, research is
showing us that evidence that insulin earlyon in type II diabetic may actually result
in such manifestations, maybe the back ofthe neck as well and the inguinal region.
00:32
Associated with insulin resistance, sometimes
seen with underlying malignancy even perhapsacanthosis nigricans.
00:40
Another skin manifestation that you would
expect to find is called necrobiosis lipoidicaand what this means is that around the area
of the skin where it’s being damaged becauseof lack of blood supply and such, that you
would find oval, irregular, indurated withcentral atrophy and yellow pigmentation referring
to your lipid that you might find with red-brownmargins.
01:06
There is necrosis that’s taking place locally
with deposition of lipid known as necrobiosislipoidica.
01:13
Uncommon but could be seen with patients with
pre-diabetes or diabetes.
01:18
Obviously, this has nothing to do with acanthosis
nigricans.
01:22
Often asymptomatic, usually that’s found
on the shin.
01:26
The way that you would treat this is not very
effective, but you still would have to givetopical steroids.
01:32
For ulcers, you’re worried about, once again,
the development of gangrene and perhaps therisk of amputation therefore cyclosporine,
oxygen and maybe anti-TNF therapy with infliximab,steroids and other therapies.
01:48
There’s a wide list here, at least be able
to, at this point, identify necrobiosis lipoidicathat-that could be a rare complication, but
still quite relevant to any case that youare going to be looking at.

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